Director Quality Improvements & Accreditation ( URAC and NCQA)

Location: Rosemont, IL, United States
Date Posted: 03-10-2016
Opportunity to drive Quality improvement initiatives and Accreditation process for NCQA and URAC for our client - a fast growing specialty benefits management company (a wholly owned subsidiary of #1 managed care organization).

.Responsibilities:
Serves as point of contact, coordinating and collaborating with URAC and NCQA accreditation entities and business partners to ensure compliance with accreditation requirements. Prepares enterprise for accreditation submissions and reviews. **Serves as the SME for applicable accreditation standards. **Develops tools that assist in determining exposure to accreditation risks and identifies opportunities to manage and mitigate those risks. **Compiles information related to quality improvement and accreditation monitoring activities for internal use and external audits and maintains relevant records. **Monitors improvement action plans relating to accreditation compliance. **Works with business management areas to develop metrics for monitoring program objectives and policies and procedures that support compliance with accreditation requirements. **Responsible for the maintenance of the electronic distribution and housing of all related policies and procedures. **Provides guidance and input to business unit audit functions to ensure ongoing accreditation and quality compliance. **Makes recommendations to business unit partners for improvements or remediation to accreditation compliance programs. **Monitors development and use of metrics for accreditation compliance and required quality improvement activities. **Assists with the development and maintenance of all required annual Quality Program Documents serving as the accreditation SME for URAC and NCQA documentation requirements. **Collaborates with quality teams, utilization management teams, call centers and other departments on accreditation and quality improvement initiatives. **Provides primary supports of quality committee activities. Includes reporting on the department’s activities to the Quality Committee quarterly. **Assists with new hires, training, and coaching of unit associates **Participates in the budget process as needed. Ideal candidate will have
5+ years of experience in a managed care or healthcare-related experience
Significant knowledge of URAC and NCQA accreditation requirement
Project management experience
Successful NCQA/URAC accreditation process completion and continuous process improvement experience
Masters/MBA preferred
5+ years’ experience in a QA/QI related position 

Relocation available for the ideal candidate.

  
 
 
 
Contact information:
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Recruiter
Max Populi, LLC
4628 Bayard Street, #207
Pittsburgh, PA 15213-2750
Tel: (412) 567-5279
Fax: (412) 567-5198
e-mail: jobs@maxpopuli.com
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